institution
Idaho Sports Medicine Institute, Pa
Sports Medicine (Neuromusculoskeletal Medicine) Physician in Boise, Idaho
NPI 1154356624

Idaho Sports Medicine Institute, Pa is a Sports Medicine (Neuromusculoskeletal Medicine) Physician based in Boise, ID. Idaho Sports Medicine Institute, Pa practices in Boise, ID. The NPI Number for Idaho Sports Medicine Institute, Pa is 1154356624 and holds a License No. N/A FOR GROUP (Idaho).

The current practice location address for Idaho Sports Medicine Institute, Pa is 1188 University Dr, Boise, ID and can be reached out via phone at 208-336-8250 and via fax at 208-345-9514.

Location: 1188 University Dr, Boise, ID, 83706-3009
institution
Provider Profile Details
NPI Number
1154356624
Provider Name
Idaho Sports Medicine Institute, Pa
Credential
Provider Entity Type
Organization
Address
1188 University Dr, Boise, ID, 83706-3009
Phone Number
208-336-8250
Fax Number
208-345-9514
Provider Enumeration Date
07/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
805993900 05 ID
REGENCE BLUE SHIELD 01 ID GROUP # 29145
8628-0 01 ID BLUE CROSS OF IDAHO GROUP
institution
Provider Business Practice Location Address Details
Address
1188 University Dr
City
State
Zip
83706-3009
Phone Number
208-336-8250
Fax Number
208-345-9514
person
Provider Business Mailing Address Details
Address
1188 University Dr
City
State
Zip
83706-3009
Phone Number
208-336-8250
Fax Number
208-345-9514
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Neuromusculoskeletal Medicine, Sports Medicine
Speciality
-
Taxonomy
License No.
N/A FOR GROUP ()
Definition
Definition to come.
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